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For cervical cancer, when is an organ preserving approach possible where only radiation treatment is needed?

In practice of oncology, preserving an organ has either served a cosmetic reason or a functional one. For example breast conservation has merely served a cosmetic purpose but limb preservation in treatment of sarcomas, has served the purpose of preserving the function of a limb. When it comes to preserving the cervix, it’s preservation has only been important in younger women who have desired to remain fertile. So that is the only scenario when surgery would not be the treatment of choice. That is for early stage cervical cancer. As for later stage cervical cancer, surgical resection would not be at the best interest of the patient because complete resection of the tumor would not be possible and patient would require radiation and chemotherapy even after surgery. In that case, patient would most likely experience side effects of all three treatment modalities without additional benefit from surgery.

When it comes to organ preservation, the other very important factor to keep in mind is that one should not preserve an organ just for the sake of preserving it if that organ is not going to function as result of organ-preserving treatments! For example, what good is preserving a cervix would do to fertility of a woman if their ovaries are going to be non-functional as result of receiving radiation to their pelvis? Therefore, every patient’s case has to be discussed individually. One has to know the stage of the disease, the baseline function of the organ to begin with, how the treatments would affect the function of the organ one is trying to preserve but above all, how successful the treatments are going to be in eliminating the disease without compromising the outcomes.